Marlene Butteriss, QCOSS
Carer helping senior woman

An essential element of person centeredness is to think about issues of power and control. With true person centred approaches, including individualised or self-directed funding models, people with a disability and those who care about them must be the ones that are in control and have authority in decision making. It can be difficult for organisations to make this shift and begin to work with and for people.

A change in culture

Person centred approaches require a change in thinking about people with a disability and the delivery of services so that the person, and what is important to them, are at the centre.  A shift in thinking can sometimes be difficult because the differences sometimes appear subtle.

A change in culture and attitude is needed for organisations to move from asking “what can we do for this person?” to “What does this person want for themselves and how can we help?”

With a change in thinking, services can begin to separate notions such as what is important for the person and what is important to the person. Even once the ideas become separate, services may become good at separating the thinking, however it can become easy to focus on only one.

Concerns about person centred approaches

All levels of an organisation may have concerns about person centred approaches.

Managers and board members may be concerned that budgets will not sustain responding to people desires.

Professionals and therapists may see the person’s goals and aspirations as unrealistic.

Support workers may feel they do not have the skills to support a person to have a full and valued life in the community.

And all parts of the organisation may have concerns about working in a more flexible way (Salmon, 2014, p42).

All of these concerns will be addressed as people with a disability and their families become the drivers in their life.

Achieving more flexibility

Person centred approaches require that resources be used flexibly to achieve what is important to the person. The fundamental difference is that the organisation and the people who work there are able to work towards what the person wants in their life, rather than predefined service offerings.

Existing services cannot offer real choice if they simply fit people’s choice into predetermined options, this instead becomes enacted as asking people their views rather than acting on them.

Real person centeredness comes from:

  • Listening and being willing to hear and act. It calls for all parts of an organisation to listen to what’s important to the person now and into their future.
  • Giving up power over the person and being willing to work with the person’s capacities and choices and assisting them to find ways to overcome barriers.
  • A willingness to work with the person’s family, network and community to enable what is important to them to become a reality.


Salmon, R. 2014, “Reflections on change; supporting people with Learning disabilities in residential services”, British Journal of Learning Disabilities, vol. 42, no. 2 pp 141-152

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